Archived: Sanctuary Home Care Ltd - Sheffield

Updated 25 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We usually ask the registered provider to complete a registered provider Information Return (PIR). This is a document that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We did not request a PIR for this inspection as the date of this inspection was moved forward because of concerns idenfified in relation to service delivery and gaps in records from the provider and local authority monitoring visits.

Prior to our inspection we spoke with the local authority to obtain their views of the service. Information received was reviewed and used to assist with our inspection. We also reviewed information we had received, including notifications of incidents that the registered provider had sent us.

This inspection took place on 12 and 13 December 2016 and short notice was given. We told the regional manager two working days before our visit that we would be coming. We did this because we needed to be sure the manager would be available. This inspection was undertaken by two adult social care inspectors and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The area of expertise for both experts was in supporting older people.

As part of this inspection we spoke in person or over the telephone with people supported by Sanctuary Home Care Ltd - Sheffield, to obtain their views of the support provided. We telephoned 40 people supported by Sanctuary Home Care Ltd - Sheffield and were able to speak with 21 people receiving a service, or their relatives. In addition, we visited four people in their own homes to speak with them and to check the Sanctuary Home Care Ltd - Sheffield records held at their home. During home visits we also spoke with two relatives of people receiving support.

We visited the office and spoke with the regional manager, the manager, the deputy manager, two care coordinators, an office support worker and a team leader. In addition, three staff (community care workers) visited the office base so we could speak with them about their roles and responsibilities.

We spent time looking at records, which included five people’s care records, four staff records and other records relating to the management of the service, such as training records and quality assurance audits and reports.

Updated 25 January 2017

Sanctuary Home Care Ltd - Sheffield is registered to provide personal care. Support is provided to people living in their own homes throughout the city of Sheffield. The office is based in the S5 area of Sheffield, close to transport links. An on call system is in operation.

At the time of this inspection Sanctuary Home Care Ltd - Sheffield was supporting 259 people.

The service did not have a registered manager. The registered manager left three weeks prior to this inspection. A new manager commenced in post four weeks prior to this inspection and was provided with a week’s handover from the previous registered manager. The new manager has applied to register with us.. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The manager had worked at the service for approximately four weeks prior to this inspection.

Sanctuary Home Care Ltd - Sheffield had been operating in Sheffield since 2013. However, the registered provider moved address and as a result was registered with us on 8 March 2016. This inspection is the first inspection of the new registration.

The regional manager informed us that the service will cease to operate in April 2017. The service had written to the local authority advising of their intent to withdraw from providing personal care, with effect from 5 April 2017. Letters had been sent to people receiving a service informing them that the local authority would find them an alternative provider. Consultation events for staff had been arranged. The regional manager confirmed that an application to deregister will be undertaken once arrangements were in place for people to move to alternative providers.

The registered provider had implemented a voluntary embargo on all new care packages as they had identified the need for improvement in some areas. The regional manager met with the local authority on a fortnightly basis and provided them with a weekly action plan to show plans were in place and being acted upon to improve the operation and delivery of the service.

This inspection took place on 12 and 13 December 2016 and short notice was given. We told the regional manager two working days before our visit that we would be coming. We did this because we needed to be sure that the manager would be available and to arrange for some care staff to visit the office during our inspection so we could speak with them.

Most people supported by the service and their relative’s spoke positively of the staff that visited them. Everyone said they felt safe with the staff.

We found systems were not in place to make sure people received their medicines safely. Staff had not been observed to assess their competency to administer medicines. Medicine administration records had not all been fully completed to show medicine had been administered as required.

Staff recruitment procedures ensured people’s safety was promoted.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. Staff were not provided with supervision and appraisal at appropriate frequencies for their development and support.

Some people said the timing of visits did not always meet their needs and they did not always have regular care staff visiting them all of the time. Other people said they had a group of regular staff who generally arrived on time. People said staff usually stayed the full length of time identified as needed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice

Whilst each person had a care plan, these did not always accurately reflect their needs or the care provided.

The complaints procedure had not been adhered to in line with the registered provider’s policy. Some complaints had not been recorded to provide an audit trail of any actions taken in response to the complaint or the outcome of the complaint.

Some people receiving support, and their relatives or representatives said they could speak with staff if they had any worries or concerns and felt they would be listened to. Other people told us they had found the office staff less reliable and responsive when they had reported any concerns.

There were limited systems in place to check and monitor the quality of the service provided. Audits on some records had not taken place to make sure full and safe procedures were adhered to. Systems to obtain people’s views were limited. People using the service and their relatives had not been asked their opinion via surveys so that the provider could act on these. Some telephone surveys had been undertaken but the results of these had not been audited to identify any areas for improvement.

We found breaches in five of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in regulations, 9: Person centred care, 12: Safe care and treatment, 16:Receiving and acting on complaints, 17: Good governance and 18: Staffing

You can see what action we told the provider to take at the back of the full version of the report.